Simultaneous Reconstruction of Both Feet with a Vascularized Latissimus Dorsi Free Flap

Abstract

Simultaneous reconstruction of both feet with a single vascularized latissimus dorsi free flap is reported. The authors describe the repair of extensive dorsal and plantar defects, as well as of heel lesions secondary to osteitis of the calcanei. The latissimus dorsi free flap serves well in combining the classic cross-leg procedure with microsurgical techniques.

Limb Salvage After Fulminant Septicemia Using A Free Latissimus Dorsi Cross-Leg Flap

“…18 The length of time for muscle division is highly variable, depending on such factors as the vascularity of the recipient bed, the contact area between the flap and the bed, and the stimulus for angiogenesis. 21,22 Generally, it is agreed that the pedicle of a cross-leg free flap can be divided after a minimum of 4 to 7 weeks at maximum. 20 In the presented case, only the distal cross portion of the LD muscle was completely divided, 3 weeks after the free microvascular transfer, leaving the supplying pedicle intact.…”

“…The free LD cross-leg flap appears to be a very good option for coverage of bilateral extremity defects. 21,22 The main advantage consists in a simultaneous reconstruction of both feet with only one flap which, after neovascularization, can be divided under local anesthesia. Avoiding two free-tissue transfers in these types of injuries decreases the risk of failure, reduces treatment costs, and is more acceptable to the patient.…”

A case report of cross-leg free latissimus dorsi myocutaneous flap transplantation

“…Since then this procedure has been described using several kinds of flaps [2][3][4][5][6][7]. More recently, the latissimus dorsi myocutaneous cross-leg free flap has been utilized to fill large post-traumatic bilateral defects in the lower extremity [8,9]. The latissimus dorsi flap has many advantages for a cross-leg pedicled free flap in reconstruction of extensive and complex limb defects; it can provide a large flap and a relatively long pedicle with large caliber vessels.…”